18685 POST THIS CARD NEAR FRONTOF BUILDING
PERMIT NUMBER
r CITY OF CUPERTINO ", 18685
INSPECTION ,DIVISION
JOB INSPECTION RECORD''.
�
J +- PERMIT EXPIRATION
OB ADDRESS a.•tiL UNIT# _LOT# I
'PERMIT EXPIRES IF WORK
owrvER CONTRACTOR' p '(;J •IS NOTSTARTED"WITHIN
INSPECTION DAT '+, INSPECTOR' . ' .INSPECTION RECOR15 180 DAYS OF PERMIT ISSU.
FOUNDATION 'ANCE OR 180 DAYS FROM
NOTE: ' LAST CALLED INSPECTION.
UFER - ALL GRADING•AND DRAINAGE SHALL BE INSTALLED
PR EGUNITE ,• p - TO COMPLY WITH THE APPROVED PLANS AND CITY-OF ,PERMIT VALIDATION
'CUPERTINO STANDARDS.,
GARAGE SLABS - - - If�tr=N1® _
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB - SEP• 2 ;t,�989
PLUMBING -
Cit •��,IfN �C b1 l? i2. I
ELECTRICAL y.at,cllF'�EL�gq
W . ISSUANCE LATE
MECHANICAL - OLDS. ,ELECT. PLG. MECH.
El El
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED. 'Buaowc PERMIT ,c
• WOOD FLOOR •` ' INFORMATION
PLUMBING y VALU^A+TIO SIFT.
ME.CHANICAI , .V --
ELECTRICAL + - PER ITm
FRAMING ' •S �� ar^
' INSULATION � sryRus TYPEc STT .
OCG GROUP RES.UNITS;
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED o,,t5 -
• '': - ROOF _ sa IT,FLOOR AREA TOTAL ACREAGE
NOTE:NO FINAL INSP.SRALL BE MADE BEFORE 9
DIAPHRAGM THE CONSTRUCTION TAX IS PAID "
~ Cf CAti ~� "Gµ'r
ROOF SHEATHING - - - 9'-. BUILDING US[-�' + RES IND CON 're Owd.
•+•APPLY'NO ROOFING UNTIL ABOVE'HAS,BEEN SIGNED—"' ;FINALS•`" j` DATE'. .INS .'^ ❑'• ❑ - ❑' � ❑ I
ROUGH
$AN.k AssessORS Pa+CPL ND
'PLUMBING . 'ELECT.ENERGY -
TUBS 8 SHOWER PAN - - - PLUMBING ENERG TRACT NO. rARCEL NO,
MECHANICAL 0 MECH.ENERGY '
ELECTRICAL' - 'ACC.DA Tr ACL.FILE NO.
_ BUILDING ENERGY
a1
FRAMING ELECT.FINAL TEST -
INSULATION - - PLUMBING . zoNlNc ENG.SITE NO.
GAS TEST GAS '
MECHANICAL _ FIRE SPr 'ENERGYT.2A
COVER NO.WORK UNTILABOVE HAS BEEN'SIGNED HEATING,. .I > yo , ND ` ❑ ' N❑
ELECTRICAL RELEASE; PLooO Mme.
' EXTERIOR SHEAR
. A.L u.c•
❑
INTERIOR SHEAR - - FIRE DEPT. Y❑ N . Y ❑ N❑
SHEETROCK GRADE - FEE SUMMARY .
EXTERIOR LATH BUILDING__
INTERIOR'LATHTEMPORARY'APPROVALS ; - BUILOIniG DD'
,SCRATCH COAT. IT . ELECTRIC .PLAN CHECK•,
. a GAS - FEE
-NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY s SEISMIC FEE
OCCUPANCYOF BUILDING ISNOTPERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR'. MICROFILM'
'
ARRANGE FOR INSPECTION BY PHONING 252-4505; ELECTRIC,
�
o� `' ONE WORKING DAY BEFORE REQUIRED'INSPECTION
Z PLEASE GIVE JOB ADDRESS PLUMBING
,RESS WHEN PHONING.
-'SEE PERMIT FOR EXP,IFATION DATE - J MECHANICAL _pQ'
G
•CONST.TAX
IMPORTANTI
PLEASE REA&'REVERSE SIDE BEFORE .
.`CALLING FOR FINAL INSPECTION. TOTAL
OFFICE COPY . r
,
.. a..
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES',', USE BALL POINT PEN ONLY
PERMIT NUMBER
.,.� :��6 JILDING PROJECT IDENTIFICATION" APPLICATION & PERMIT
'. BUILDING 1 8 6 R V 5
AODREss - - BUILDING -ELECTRICAL-PLUMBING-MECHANICAL !%
OWNER'S - PLAN CHECK VALIDATION
NAME + '' GTV: ELECTRICPERMIT 'FEE
PHONE
CONTRACTORS "OUTLETS;SWITCHES-RECEP 10.00/1.00
NAME .`• r" - -
�C \ ,ONO. �Z LIGHTING FIXTURES 10.00/1.00
CONTRACTOR'S " - : APPLIANCES-RESIDENTIAL - 4.00
- ADOREss PLAN CHECK FEE
• U q - I`'; �u PHONE PANELS 10.00 DATE OF APPLICATION --
ARCHITECT • PANELS (OVER 200 AMP) 20.00 OR
ENGINEER LIC.NO. SIGNS TRANS. 3.00
, -
AR. ENa SPECIAL CIRCUIT 5.00 PERMITVALIDATION
ADDRESS
• ' 'LP '- EMP.METER OR POLE INS. 20.00
APPLICANT'S MOTORS SEE,FEE SCH. � '�7
ADDRESS `
SERVICE CHANGE - 20.00 f A Ut '
w o
X LICENSED C'ON'I'RAC1
'I'ORS DECLARATION L `I •1/ITV
'a u w 1 hereby affirm that I am licensed under provisions of Chapter 9 _ ISSUANCE DATE
lco room,mg with Section 7000)of Dwi,ion 3 of the Business and t Big ELECT. PLG. MECH.
N z• I'rol'essim,Code,and my license is in Cull force anA effect. f�'} ❑ ❑ Idl
z o,n - License Class Lic.Number I(} LPL
CI Z Date Contractor
H w F J
a m J,- .. BUILDING PERMIT
C, w OWNER-IWHOER DECLARAT ION, INFORMATION
E.w 3 n m 1 hereby affrm that I am ex mpt front,(lie Contractor s Leense MISC:- REFER TO ORD VALUATION $/FT.
HLLDa. Law for the following mason (Shea 7031,5,BIln sand Prrfes ions pERM1T'ISSUANCE - 10.00 0®
Cotte:Any city or county which requires a hermit to construct,alter,
2QQ improm
ve,deolish,or repair apr
any structure, ior to its issuance,also ELEC.COSTA. LIG NO.ic
ELEC.
- O C requires the applicant for such permit to file a signets statement that TOTAL PE IT TO
a
X " he is licensed go...mt to the provisions ot'do,Contractor's License - - -
i
Law(Chapter 9(commencingwith Section 7000)of Division 3ofthe - � `(`Q �e
' a tlusiness and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE
F Z p STORIES TYPE C NSTR.
$ the basis for the alleged exemption.Any violation of Section 7031.5 -
ic Gy any applicant for a permit subjects the applicant toacivil penalty ALTER-DRAIN III VENT-WATER (EA.) 5.00
of not more than five hundred dollars(S50(i
❑ 1,as owner of the property,or my employees with wages as BACK-FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS
their Sole compensu mn,will do the-work,and the structure Is not -
intended nr offered for sale (Sec. 7044; Business and Professions - DRAINS'-FLOOR,ROOF,AREA,COND. 5.00
Code:The Contractor's License Law does not apply,to an owner of - '
property who builds:or improves thereon,and who does such work FIXTURES-PER TRAP. '5.00 SO.FT FLOOR AREA TOTALACREAGE
himself or though his own employee s.provided that sdch improve- GAS-EA.SVSTEM-11NC.40UTLETS 6.00
menti are not intended or offered for sale.1(,however,the building
or improvement is sold within one year of completion, the owner. GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING usE
builder will hdve'ther burden of proving thaLtic did not build or i n - RES MD CON PB Other,
proveforpurposeofsale.). INDUSTRIAL WASTE INTER. 30.00 El❑ I,as owner of the property,am exclusively contracting with
licensed amtmclors.to construct the proiect(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCELNO.
i. and Professions Code'I lie Contractor's I.icense Law does not apply -
to an owner of-propeny who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a tontnicuips)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 - TRACT NO. - PARCEL NO.
the Contractor',License Law.' -
❑.I no exempt under Sec. BAP.C.for this MATER HEATER W/VENT 6.00
reason
Owner Dave WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO.
WORKERS-'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 -
_ I hcrchy affirm}hat I hove o ccrtificalc of consent to,elf-insure, ` ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified -
copy thereof(See.3800,Lab,C.). t
Policy No. Company - - -
'' Q ❑ Cctlified 'opy is hcmhy furnished - - FIRE SPRINK ENERGY T 14,
Z_ Z- Q� Cnr lfied pis'f�ed� ' It the it inspection Division. MISC.- REFER TO ORD. Y [3 No YC] NEI
A plicant,
' H'TPERMIT ISSUANCE 10.00 ' FLOOD ZONE A.L.U.C.
- CGRTIFIC'ATB OI'Exi.x TION PROM WORKERS', - - - -
LU >_ I- COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
11 TOTAL Y IN Y ❑ N[]O
1'1'his section need,not be completed if rile permit is for one '
Z' ' hundred dollars(81001 or less.)
U O 1 certify that in the performance of the work for which thio per- CITY. MECHANICAL PERMIT FEES FEE SUMMARY
U I- mit R issued,L shall not employ any person in any manner so as to
U "cmncsahjedt to the'Workers'Compensation Laws of California. BUILDING
CL Date Applicant ALTER OR ADD TO MECH. 5.00 " 7 - Qd
} W NOTICE TO APPLICANT: If.'air"making this Certificate of Ex-
",.� Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 .PLAN CHECK
provisions of the Labor Code, you must forthwith colnply with FEE
U, such provisions or this permit shall be decned revoked: AIR HANDLING UNIT(TO 10=C.F.M.) 4.00
coNSTRufnoN l.liND1Nc'AGIiNcy; AIR HANDLING UNIT(OVER.10,000 C.EM.) 6.00 SEISMIC FEE, I'
1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 .���
the pert ormance of the work for which this permit is issued(Sea.WEI0
MICROFILM
3097,CivCJ. G UNIT(TO t 00,000.B.T.U.) 6.00 Q�
, Lender's Name NG UNIT(OVER 100,000 B.T.U.19.E ELECTRIC 'Lender's AddressI certify that l have read files applicminn and State that the aboveLATION FAN (SINGLE) 4.00inormation is correct. I-agree to comply with all city and countyPLUMBING
ordinances and state laws relating'lo huilding construction, and -COMP 13 H.P.Or 100;000 B:T.UI' 6.00 'hereby authorise opresenlatives of this city to enter"upon theR-COMP (Over 100,000'TUI SEE FEE SCH. MECHANICALabove-mentioned properly for inspection purpo c%.� '(We) agree.to save, indemnfy and'keep harmless the City of : REFER TO ORDupertino against liabilities,judgments, costs and expenses which .U�. CONST.TAX
may in anyway accrue against said City in consequence of theT ISSUANCE' 10.00 mnfi0�ofthispermit - LIC.NO. MECH.k,_ _ \.IJ -27- g� TOT OD ' TOTAL. 7 1
PagnaturvOtAppReamiCoorGardtor Date.
- j OFFICE COPY